Category Archives: Uncategorized

A Hidden Epidemic

In my first job out of residency, I worked with another new physician.  Let’s call him Bill.  Bill was a warm, caring and generous, but highly anxious, person. He worried about everything: every patient he took on, every decision he made, every lab that was even remotely out of range.   My partners and I also suspected there were things going on in his personal life that were troubling him but we wanted to remain professional.  We didn’t want to pry or to make him feel uncomfortable.  We figured he was just like many of us… trying to sort out his new role as physician, finding a way to make it fit into his life.  Then one day Bill didn’t show up for work.  We contacted his family, who lived out of state, and they hadn’t heard from him.  Later that day, Bill’s body was discovered in the river.

In our last all provider meeting, we discussed the new regulations requiring health care providers to have a certain number of hours of training regarding suicide.  As the requirements and options for training were being laid out, I couldn’t help but think of Bill and of our medical profession as a whole.  The figures are frightening.  The equivalent of nearly 2-3 medical school classes of physicians die by suicide each year.  Male physicians are about 1.5 times and female physicians about 2.5 times more likely to die by suicide than the average person.  Not only do we need to undergo training for suicide risk detection and prevention for our patients, but, it seems, we desperately need it for ourselves as well.

The role we have chosen for ourselves is difficult.  It has many rewards, of course, but it also can take its toll on self and family.  As a group, we tend to be harder on ourselves than we are on others.  We hold ourselves to sometimes unrealistic and unhealthy standards.  We are excellent at delayed gratification and dedication to others before self.  We want to please and have a hard time saying no.  We put our lives and families and finances on hold to complete our training and to build a practice, only to be met with what sometimes feels like a lack of appreciation for our efforts.  And the ultimate goal of our calling, the development of a close and caring relationship between doctor and patient, is eroded by the seemingly endless administrative duties which are taking over our day-to-day lives.  And if we do ultimately feel like medicine is not the right place for us, we often feel stuck  – without other skills, saddled with huge debt, and lacking time to pursue other options.

We need to begin to care for ourselves as we care for our patients.  We would never suggest that our patients work 60-80 hour weeks, skip meals, get too little sleep, defer family time for more hours at work, take only a few weeks of maternity or paternity leave, etc.  This is not a humane way of living and it is unsustainable.  We need to support each other as coworkers and in an organizational capacity in pursuing quality of life in the workplace and at home.  Our emotions – all of our emotions – are not weaknesses.  They are part of what makes us human.  We need to acknowledge this as a profession and work to get rid of the stigma that surrounds mental health issues in healthcare providers.  And, finally, we need to be there for each other if one of us is struggling.

Some of us worry that reaching out for help would be an admission of weakness or would signal to others an inability to practice in the best interest and safety of our patients.  So we don’t reach out.  Many of us have long office hours and spend more hours after work completing charting and don’t see a time to be able to attend counseling sessions.  So we don’t reach out.  But we have to find a way to break down these barriers to care.  Below are some of the resources available to us that are confidential and will work around our hectic schedules, we just have to be willing to get started.

None of us can travel this road alone.  If you are struggling, please reach out and let someone help you.  After all, wouldn’t you do the same for another in need?

·        The Spokane County Medical Society (SCMS) Foundation offers a Wellness Program which is staffed by psychiatrists who specialize in treating medical professionals.  There is complete privacy and confidentiality (providers are referenced by number only and providers can either choose to go to the psychiatrist’s office or there is a separate room with a separate entrance at the SCMS offices that facilitates anonymity).  For SCMS members, the  1st 8 sessions are free.  Sessions are contracted at lower rates for non-members.  Mental health providers are available 24/7 by pager and can be reached at 509-720-6000 (if not immediately available, a message can be left which the recording states will be returned within 10 minutes).  You can find out more about the SCMS Foundation programs at


This Is Me

This is me.

I am Doctor, Mother, Wife, and More.

I am Confidence Keeper, Amateur Counselor, Health Promoter and Sickness Healer.                       I am Patient Protector, Part-time Teacher, Dream Inspirer and a Sometimes Friend.

I am Meal Maker, Homework Helper, Heart Healer and Expert Worrier.                                             I am Story Teller, Back Rubber, Booboo Kisser and a Tucker in Bed.

I am Travel Planner, Errand Runner, Special Maker and Photo Taker.                                                   I am Memory Maker, Party Planner, Love Giver and the Keeper of Kin.

I am Shower Singer, Daydreamer, Nature Lover and Wannabe Writer.                                                 I am Cause Fighter, Alone Time Hoarder, Age Defier, and the Fiercest of Friends.

This is me.

And who are you?

I Rise Early

I rise early, hoping to steal some time alone with my thoughts.  It’s quiet at the lake in the morning… except for the symphony of sound.  The honking of geese miles away bounces off the mountains.  Squirrels titter in the trees.  There are high-pitched squeaks and guttural whale-like sounds, forced from adjacent docks as they rise and fall with the lapping of the lake water.  The bees begin their gentle hum.  In the distance, a bird calls but there is no answer.  A car engine breaks the silence, then quickly fades away.  Even in the stillness there is motion. Nature is an early riser, just like me.

The lake smells of smoke this morning; like a thousand campfires left smoldering to ash.  Yet past the smoke, or maybe underneath it, there is a freshness, a clean smell; something subtle that you can’t quite put your finger on.  Had I a better nose, I might smell the sweetness of flowers growing in the planters below or the piney scent from the surrounding trees.  But the only thing wafting my way this morning is the smell of coffee.  Lights are on in the cabin. Someone has turned on the coffee pot.  My youngest son, now awake, snuggles up on the couch in a cozy blanket as I grab the few remaining moments of quiet… before the rest of the world awakes.

Even now the light is rising, as if on a dimmer switch in reverse.  The mountains become clearer on the horizon.  Smoke from distant fires layers across the treetops and blankets the sky.  A slight breeze picks up, creating tiny ripples on the water.  A lake otter swims alone along the shoreline.  Boats begin their journey across the lake, white tails of water trailing behind; fishermen in search of that perfect secluded spot to catch their prize.

As my senses are gently coaxed awake, I wonder…. Do night owls, late to bed and late to rise, find the same quiet and peace in the nighttime?  When they wake, in the height of the day, do they wake to an assault on the senses?  I cherish these early mornings and their treasures of sight and sound – these moments with Mother Nature, before our busy days begin.

Game of Thrones

Well, you know you haven’t been contributing to your blog enough when you aren’t even getting spam comments (such as “I love your blog post! Check out my site for discounts on Viagra). Apparently, I have fallen totally off of the blog grid. It has been a month or more since I have written anything for my blog. I can hear you judging me so you should know that I have been writing other stuff. My writing energies lately seem to be spent on my medical passions of preventive care (please, everyone out there, get your vaccinations) and physician wellness. However, I do admit that my attentions are also drawn toward non-literary pursuits…. Damn you, Game of Thrones.

Whomever wrote and produced this series obviously just didn’t want anyone to get anything done. My husband and I are watching it on DVD and there have been many a day where I want to do nothing else but see what Daenerys Targaryen is going to do with her wayward dragon children or how Arya Stark is going to track down and kill every last person on her bedtime kill list. By the way, has anyone else noticed how the women of Game of Thrones are kicking ass and taking names? You go girls! And then there’s John Snow. He’s yummy.

You know your Game of Thrones addiction has gotten out of hand when your children are complaining that you never spend time with them in the evenings and that you are always kicking them out of the room so you can watch said TV show. I feel kinda bad about this. But obviously not too bad because I continue to do it.

Does anyone else also worry that their neighbors are going to look in their window and think that they are watching porn? We have this big picture window in our family room and I have to draw the curtains sometimes because of all the nudity happening on the screen. Maybe I’m a little prudish but I don’t want people getting the wrong idea.

In younger days, before kids, my husband and I would spend hours binge watching 24, convincing each other that we could stay up for “just one more” and not be too tired the next day. Now, it is one and done. I must be getting older. In my heart of hearts I am young enough to stay up until midnight watching multiple episodes but, in reality, I have to get up at 5 AM and it ain’t pretty around my house if momma doesn’t get her sleep. So, it is taking us a while to get through the series.

We are finishing up season four and I can’t wait to see what happens next! If you are caught up to present day, please don’t give away any secrets. But, I am praying to the Gods, to the old and the new, that Jaime Lannister will fall out of love with his witch of a sister and find love with Brienne of Tarth and that Arya’s Needle will find its way into the hearts of her foes and that The Mother of Dragons and John Snow will rule over the Seven Kingdoms together. Do you see what you are missing if you are not watching this show? But, beware. Start it and your sleep, your relationships with your children, and your ability to get anything done may suffer.

Mom, Wife, Doctor, Activist

If you had asked me a year ago if I ever thought I would be active in political discussions, working to effect policy, protesting, and organizing I would have said “Absolutely not!” I don’t like to call attention to myself. I prefer to work behind the scenes and effect change one person at a time. I would rather hide behind my stethoscope and my pen and paper than put myself out there at risk of having to speak for a cause and take on the establishment. But the election of Donald Trump, with his ensuing systematic attempts to dismantle the rights and protections of others as well as to defund organizations that have contributed to the enrichment of our culture, the betterment of our society, and that have worked to advance our understanding of and our respect for the world around us, has turned me into what I am today. In addition to my roles as Mom, Wife, and Doctor, I now also don the hat of Activist. I no longer feel that I can rely on others to ensure protection of my liberties, of our liberties. Look what happened when we assumed that the American voter would make reasonable decisions about who to elect as President of the United States. All Hell broke loose.

And I am not alone. In fact, the Trump presidency has created the greatest generation of activists that this country has seen in a long time. Never before have we seen so many people organized around a cause. Perhaps this will be his only positive lasting legacy. The large majority of Americans, whether they would admit to it in public or not, are nervous about what is happening in our Government right now. Trump is taking aim at some of the very institutions that have made this nation great. He is doing the opposite of what his campaign slogan promised. He is making America dangerous, intolerant, hateful, and the laughing stock of the international community. He is setting back the advances we have seen in race relations, gender equality, LGBTQ rights, health care, international relations, environmental protections, and the list goes on. He forgets that we are the United States of America. Every time he removes freedoms from one of us, it threatens the safety of all. Every time he takes aim at social programs for one group, it weakens the societal safety net of all Americans. And I, we, cannot stand by and let him unravel this beautiful patchwork quilt of diversity and liberty that is our great nation.

It is as if he is trying to cross off a check list, one item at a time; trying to undo every measure or bill put in place by the Obama administration, just to say he lived up to a campaign promise. Never mind the fact that he and his sycophantic cabinet offer no realistic or reasonable alternatives or replacements. And the American people are becoming wise to his game. He is a figurehead only, and a very poor one at that. And for all the obstructionist tactics the Republican Party has used over the last eight years of Obama’s presidency and for all the talk of bridging the party divide, he is making no efforts to bring Democrats and Republicans together to develop solutions. Instead, he is ramming presidential order after presidential order down our throats like he’s in some race to the finish line. Perhaps he sees that his tenure in the White House is coming to an end and this is a frantic dash to do something, anything that he promised on the campaign trail. Otherwise, his presidency would be an unmitigated failure and he himself would be a national embarrassment. Well, Mr. President. It is too late for that.

The March for Science is coming up on April 22. In contrast to the dozens of people that showed up to the Anti-vaccine movement’s March for Truth yesterday in Washington, DC, the nation is again going to witness the huge outpouring of support that the world has for its fellow citizens, its planet, and for reason and fact. The March for Science will bring tens of thousands, perhaps hundreds of thousands, of people from around the world to speak out against Trump’s anti-health, anti-environment, and anti-intellectual agenda.

Without the Environmental Protection Agency, we would have many more deaths due to poor air quality, many more children poisoned by lead in their drinking water, many more species on the verge of extinction, many more instances of severe and damaging weather. Without Planned Parenthood, we would have even higher numbers of pregnancy terminations (since more accidental pregnancies would occur without access to birth control), greater numbers of sexually transmitted infections, and higher rates of cervical and penile cancers. With the doubt and fear mongering that Trump plans to disseminate in questioning the efficacy and safety of vaccinations, he would set public health advances back to the 1700s when we saw millions of people die from vaccine-preventable illness. Does he even know how many organizations (both government funded and private) are already devoted to monitoring the safety of vaccines? I count at least eight and there are undoubtedly more. Yet he would have us believe that 220 years of vaccine science is false, inadequate and needs to be redone. And who’s going to pay for that?

If we love this country and we want to preserve the rights and dignities of all Americans, we must stand up and let our voices be heard. If we stand for truth and justice and equal opportunity for all, we must stand against Trump and his administration. His policies may not directly affect you or your loved ones now but, if we allow tyranny and prejudice to stand, who’s to say what group he will target next. His words and actions are not Christian (nor are they consistent with the messages of love and tolerance that are central to the teachings of all of the major religions), they are not American, they are not even Human. Most of us are born with an innate instinct to show care and compassion for our fellow humans. This moral compass seems to be lacking in president Trump.

So, I hope that you will join me at the upcoming March for Science rally on April 22. Let your activist flag fly.  Speak up for that which you believe. Help bring this reign of absurdity to an end.

A Prayer for Today

Dear Lord,

Thank you for your many blessings. May they keep me sane during these times of trial.

Lord, I am having a difficult time finding the goodness in everyone. Help me loveth my neighbor, no matter who they voted for. Help me to find something positive in this “presidency”. Perhaps you have sent us this erratic, insecure, uninformed lunatic to draw contrast to that which is just and right in the world. For humans banding together in support of each other and against hate is truly Good.   Let me not harbor feelings of ill will towards him or those that support him but understand what drew them to him in the first place.

Lord, help me to survive the 13-year-old rollercoaster that is my eldest child. Hold my tongue, Lord, so that I may not say something I regret when he has challenged me one too many times. Hold my hands, Lord, when he changeth my radio station and toucheth my gearshift while I am driving. Help me to enjoy the snuggles that have inexplicably returned following a multi year absence, only to be followed by yelling and slamming of doors. Let me not sell him to the gypsies, as he will someday regain his full faculties and become a rational human being again.

Lord, please relieve us from that which is white and falling from the sky. It was beautiful in December and January but now it maketh me want to hurt myself, or others. Bring blue skies and sunshine and shoots of green. Bring birdsong and flowers. Help me to find my inner peace and joy so that my family does not have to suffer my gray moods.

Lord, help me to find strength in you. Help me to find my spunk, my childlike joy and wonder, my sense of humor, and my strength and grit in the face of adversity. Help me to love and forgive. Help me to fight for others without losing myself in the process. If you could just help me to channel my inner Rose Nylund, Julia Sugarbaker, and Anne Shirley then I’m sure I’ll get there.

Please send peace and love and safety and health to all, even to you know who.



And so we will Stand,                                                                                                                                     just as we had planned,                                                                                                                               with our heads held high.

I sit here, muscles in spasm, gripping my nerves and skeleton.  I cannot sleep.  I have my second cold sore in as many weeks and I am just now coming to the realization that I am stressed.  The body often reveals what the mind cannot see.

The kids are good.  My husband is loving.  Everyone’s healthy (save that cold sore and the spasmed muscles).  Work is rewarding.  I love the time I spend with my patients and coworkers. I love teaching.  But providing health care is a fight.  A constant fight.  And there are wolves at the door, threatening to take away the care and coverage that so many need and from which so many have benefitted.  And then, there’s Inauguration day looming.  It is enough to make a person want to lay down, roll over and wish the next four years away.  But we can’t.   Now is the time to say what must be said.  Now is the time to let our voices be heard.  Now is the time to stand.  I don’t know about you, but I don’t want to look back on anything that happens in the coming four years, anything that takes away rights and freedoms and opportunities for others, and say that I could have done, should have done, more.  I hope you will join me in taking a stand on January 21st at your local Women’s Day march.  Join the greatest gathering of activists that this country has seen in some time.  Be a force for change.  Stand.


Dear Family and Friends

Dear Family and Friends who voted for Trump,

Much has already been written along the lines of what I am about to say, and often more eloquently than I may say it, but I am trying to deal with the aftermath of this election and writing is my outlet.  I have something that I need to say and I hope that you will hear it.  I have never been one to get very involved in politics but I don’t feel like I can sit around and be an observer in these events any longer.  I love and respect you all and I know that you voted for Trump, not in support of his bigotry and malice, but as a vote for change.

The thing is, in voting this man into office, Trump supporters seem, inadvertently, to have given license to all of those who have been hiding their racism and sexism and homophobia. With Trump elected to office, the message has been given that it is okay to spew hatred.  The Internet is rife with stories: men groping women on the street, people tearing the hijab from the heads of our Muslim sisters, spray-painting the “n” word all over business walls and school bathroom stalls.  Our children are afraid.  Our people are afraid. With this election, we have set the country back, not taken it forward.

Now is your opportunity.  You have the chance, the RESPONSIBILITY, to not sit back and let your party be defined by bigotry and hate (for that is how it is currently being viewed by many).  You have the opportunity to re-define what it means to be a Republican.  But it has to come from you.  People within your own party must be the ones to speak up.  What’s happening in our country right now is NOT OKAY. 

Many of us have been privileged in some way, whether we are white or male or heterosexual or educated or wealthy.  It has been easier for us than for many.  As humans, as people with generous hearts and kind souls, we have to act on behalf of others.  Day to day, we can stick up for someone on the bus who is being harassed, we can give to organizations that help the disenfranchised, we can write or call our congressmen and congresswomen to let them know that we will not support them if they endorse the bullying and denigration of others, be it by everyday citizens or by the President himself.

Keep your eyes and your ears open.  I understand wanting to stay off of Facebook and turn off the news so that you don’t have to deal with all of the negativity and divisiveness.  But don’t allow yourself to turn a blind eye to the events that are taking place.  Don’t assume that someone else will speak up.  We must all accept responsibility for what is happening and work to make things better.  I challenge you to do what is right and to go forth and put some love and hope back into our world.

Please.  If you love and respect me, if you love your children and want them to live in a nation that is peaceful and safe for all, if you love your country then STEP UP AND SPEAK OUT. 

Thanks for hearing me out!

Wishing you all peace and love.


The Struggle is Real

You’ve heard of the Urban Dictionary?  Well, I’m coming up with a Nine Year Old Boy Dictionary. I’ve lived with this strange being long enough that I am starting to learn his lingo and thought others of you might be able to benefit from my experience.  It is a work in progress and I would love your feedback.  Perhaps you can share some of your own definitions so that we may all understand and communicate with these creatures better.  Please use this list of words and phrases for your English to Nine Year Old Boy translation needs.

English:  Nine Year Old Boy

  1. Now:  In 5 minutes, or 10 minutes, or maybe never.
  2. Hustle:  Move at exactly the same speed as you are currently moving.
  3. Weird:  Anything having to do with kissing, or romance in general.
  4. Use your fork:  Eat your salad with your hands.
  5. Get ready for school:  Listen to music and play with your Legos, being entirely not ready for school when it is time to leave.
  6. Brush your teeth:  Stare at yourself in the mirror for 5 minutes, making silly faces and checking out your muscles, then swish with an infinitesimally small amount of toothpaste so as to make is it smell like you have brushed your teeth.
  7. Wash your hands:  Turn on the water and wave your hands in its general direction.
  8. No:  Yes. As in, the reply given to the question, “Did you wash your hands?”
  9. Read a book:  Find something resembling a book but with no words and look at it for 20 minutes.
  10. Take a shower:  Run the water for 10 minutes to let it “warm up” while you play with your Legos. Then, stand under the water for 20 minutes and sing, perhaps using the soap as a microphone, getting no actual soap on your body.

I’m looking forward to hearing from you!  I need as much help as I can get!

I Took a Walk

The first real snow of winter… its beauty stole my attention from whatever errand I was running that day. The light reflecting off the snow was a beacon, directing me toward solitude and peace. I pulled the car into the parking lot. I shut off the engine and my distractions and sat quietly for a moment, soaking up the last bit of warmth from my car and gazing at the wintry scene that lay before me. The ground was blanketed in white. Very few footsteps disturbed the snow. It was early still. Another week and the snow would be worn to earth by sleds and skis and snowshoes.

I stepped out into the cold, crisp air.   Showers of snow fell from the tree ahead of me, crystals dancing across the light breeze, caught in the light of the rising sun. I walked toward the pond, remarking as I went how a fresh coating of snow can make anything seem light and pure. Old, dilapidated houses, lit up by twinkly white lights and a dusting of snow, suddenly looked beautiful and serene.

Along the path to the pond were looming lampposts. A worn green veneer, covered in snow, recalled a time since past – a time of radio shows and model Ts, a time of simplicity and innocence. It was quiet out and the world was still. People were just rising from the warmth of their beds, covers pulled high. The sound of snow crunching beneath my feet was the only break in the silence.

At the pond, I veered left and walked to the hillside where a path ran along the length of the park. It was a favorite place for runners in the summer time. But right then, in the early winter morning, there was just me. I paused to gaze at the sun as it rose behind the hillside. The giant evergreens cast long shadows across the snow. The sun twinkled through their flocked branches.

Life these days is fast paced and full of distractions. I try to remember to slow down once in a while, to live in the moment, and to appreciate what is around me. This day, I did just that. I took a walk and enjoyed the world that lay before me, a world that never ceases to amaze me with its beauty and grandeur.